14 Dec, 2017

Getting out of breath for any minimum activity, always feeling fatigued, by the time I turned 37, I knew that I was in trouble. Scared of operations, phobia for doctors but still I had no option but to visit one.

After ECG and echocardiogram tests I was detected with dilated cardiomyopathy. A genetic disorder which affects the ability of my heart muscles to pump blood effectively. I have seen my father expire at a very young age owing to the same disease.  A child studying in kindergarten, the fear of parting from my near and dear ones, a family to take care of…. It was like losing all hope.

I was put under heavy medication to control blood pressure and heart rate. I was given beta blockers, anticoagulants and medicines to strengthen my heart muscle. In five years, things went from bad to worse. I had pleural effusion and was under ventilation for a couple of days. I developed mild asthma. Normal breathing became difficult for me. My ejection fraction was gradually decreasing. By the time I was 43, I had difficulty to walk and was constantly fatigued. All I wanted to do was either to sit or lie down. By now, my heart was pumping only 25 per cent of the blood that it should with each beat and “I was struggling to survive,”

It was around this time I learnt about advanced pacemakers that did more than just correct the slow beating of the heart. These were state-of-art pacemakers that understood the heart, and could feel its rhythm and correct it. If they sensed trouble, they could even give the heart a mild electric jolt to put it back in track.

I went to B.M Birla Hospital and met Dr. Anil Mishra a senior Cardiologist. He informed me that we’ve had Traditional pacemakers that got the heart to beat at a particular pace, whether a person was walking, sleeping or exercising. They were not programmed to understand when the body needed the heart to beat faster (such as when climbing stairs) or when it needed it to slow down.

Today’s pacemakers are mature, smaller, thinner and, more importantly, compatible with diagnostic tests such as MRI scans. The older metallic pacemakers were a hazard inside magnetic scanning chambers, and all patients implanted with the device would be warned of the risks to both body and device. Now the internal circuit, external body and leads of a pacemaker are all made of non-ferromagnetic material that are unaffected by Magnetic  rays.

Instead of going for the traditional pacemaker, which would only nudge the heart to beat with metronomic regularity, I was advised to opt for the cardiac resynchronisation therapy (CRT) heart device along with defibrillation therapy device, (CRT-D). The smartest of the lot, this multifunction device has the ability to detect and treat dangerously fast heart rhythms, or speed up a heart that is beating too slowly, or give a mild electric shock if the heart is about to let you down. It is equipped to control heart rate as well as prevent heart failures and, thereby, prevent sudden cardiac death.

45 days since I have got this device implanted, I call The “Second heart”, I am able to live a “normal life”. “There was a time when I couldn’t walk or drive and would have to call a cab to take me home from office. A party or get together would leave me exhausted for days.” Now everything has changed miraculously I am able to walk 4 kms without getting out of breath. I am more energetic in office and don’t go back home exhausted. Tests show that my heart is pumping more blood now … 30 per cent, though not optimum yet but it’s getting there.

CRT-D implantation isn’t complex. “The procedure was performed under local anesthesia and lasted for about 3.5 to 4 hours, It does not require an open heart surgery. A small incision, about three-inch-long, was made in the upper chest, three leads, were pushed into the heart and the CRT-D device lodged under the chest muscle. After three days of hospitalization, I went home. A check-up was recommended after three months then six months and after that yearly. The battery will be regularly monitored and needs replacement every seven to eight years. Researchers at the University of Michigan are,  working to develop a new kind of pacemaker that can be powered using kinetic energy generated by the vibrations in the chest as the heart pumps blood.

With  genetic disorders,unhealthy lifestyle, hypertension, leading to coronary diseases, affecting more than millions of Indian, these pacemakers are gaining importance day by day . Like in every medical procedure, there is a slight risk of infection. In this case, it is one to two per cent worldwide. That’s indeed a small risk certainly for a return to a near-normal life………..The Second life……


Aninda Majumdar